During the 2016 presidential campaign, Donald Trump railed against the “failing” Obamacare and said he would replace it with “something terrific” once in office. He’s pushed Congress hard to overhaul a law that he says is “collapsing” and hurting American families.

But it’s never been clear just what, exactly, Trump had in mind. He’s praised single-payer systems in Canada and Scotland and said that Australia’s government-run approach produces “better health care than we do.” And now, as Republican efforts to repeal the Affordable Care Act seem destined to fall short, some critics are blaming his failure to lay out a clear vision for the defeat.

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Part of the problem, Republican lawmakers have grumbled privately to reporters, is that the president seems to have a thin grasp on the substance of health care. Some outlets have even reported that during the campaign, he often confused Medicaid with Medicare.

On Wednesday, Trump bragged to the New York Times, “I know a lot about health care.” But he demonstrated just how thin that knowledge is as he struggled to describe the difficulty of enacting reform. “So pre-existing conditions are a tough deal,” he said, in comments that puzzled health care wonks. “Because you are basically saying from the moment the insurance, you’re 21 years old, you start working and you’re paying $12 a year for insurance, and by the time you’re 70, you get a nice plan. Here’s something where you walk up and say, ‘I want my insurance.’ It’s a very tough deal, but it is something that we’re doing a good job of.”

So, what does Trump really think about health care? Judging from his circuitous, contradictory, and downright confusing comments over the years, it’s not clear even he knows the answer.

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“If you can’t take care of your sick in the country, forget it, it’s all over. I mean, it’s no good. So I’m very liberal when it comes to health care. I believe in universal health care. I believe in whatever it takes to make people well and better.” — Larry King Live, 1999

“I’m not going to cut Social Security like every other Republican. And I’m not going to cut Medicare or Medicaid.” — The Daily Signal, May 21, 2015

“You have to be hit by a tractor, literally, to use it, because the deductibles are so high, it's virtually useless. It is a disaster. And remember the $5 billion website? $5 billion we spent on a website, and to this day it doesn't work. I have so many websites, I have them all over the place. I hire people, they do a website.” — Town hall meeting, June 16, 2015

"The only way the government should be involved, they have to make sure those companies are financially strong, so that if they have catastrophic events or they have a miscalculation, they have plenty of money. Other than that, it's private." — The Hill, July 29, 2015

"There's many different ways, by the way. Everybody's got to be covered. This is an un-Republican thing for me to say because a lot of times they say, 'No, no, the lower 25 percent that can't afford private'… I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now … the government's gonna pay for it. But we're going to save so much money on the other side. But for the most it's going to be a private plan and people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything." — “60 Minutes,” September 27, 2015

“We’re going to work with our doctors. We’ve got to do something. ... We’ll work something out ... Nobody knows health care better than Donald Trump.” — Interview with ABC’s “This Week with George Stephanopoulos,” January 30, 2016

“We have to come up, and we can come up with many different plans. In fact, plans you don't even know about will be devised because we’re going to come up with plans—health care plans—that will be so good. And so much less expensive both for the country and for the people. And so much better.” — Interview with Dr. Mehmet Oz, September 15, 2016

“Once we break out—once we break out the lines and allow the competition to come ... President Obama, by keeping those lines, the boundary lines around each state, it was almost gone until just very toward the end of the passage of Obamacare … We’re going to block grant into the states. We're going to block grant into Medicaid into the states .. so that we will be able to take care of people without the necessary funds to take care of themselves.” — Second debate with Hillary Clinton, October 9, 2016

“Together we’re going to deliver real change that once again puts Americans first. That begins with immediately repealing and replacing the disaster known as Obamacare … You’re going to have such great health care, at a tiny fraction of the cost—and it’s going to be so easy.” — Campaign rally in Florida, October, 2016

“I told him I will look at his suggestions, and out of respect, I will do that. Either Obamacare will be amended, or repealed and replaced.” Interview with Wall Street Journal, November 11, 2016, in which he discussed meeting with President Obama.

“[W]e’re going to do it simultaneously. It’ll be just fine. We’re not going to have, like, a two-day period and we’re not going to have a two-year period where there’s nothing. It will be repealed and replaced. And we’ll know. And it’ll be great health care for much less money. So it’ll be better health care, much better, for less money. Not a bad combination.” — "60 Minutes," November 13, 2016

“It’s an unbelievably complex subject. Nobody knew that health care could be so complicated.”— Meeting with governors at White House, February 28, 2017

“The longer I’m behind this desk and you have Obamacare, the more I would own it.” — Wall Street Journal, April 12, 2017

“You have to know your subject. And that would be the misconception of misconceptions for that. I mean, it’s not that I–look, I always had health care for my company. But it’s not that I—it was just something that wasn’t high on my list. I had people that negotiated for my company.But in a short period of time I understood everything there was to know about health care. And we did the right negotiating, and actually it’s a very interesting subject.” — Time magazine, May 11, 2017

"I think we’re probably in that position where we’ll let Obamacare fail. We’re not going to own it. I’m not going to own it. I can tell you, the Republicans are not going to own it.” — Remarks to reporters, July 18, 2017

“The Republicans never discuss how good their health care bill is, & it will get even better at lunchtime. The Dems scream death as OCare dies!” — July 19, 2017 on Twitter

“Repeals burdensome taxes, big … Will provide better coverage for low-income Americans. By the way, low-income Americans under our plan—and we're doing things at this meeting which I think you'll be very happy about, because we're going to spend some more money to make sure everybody is protected.” — Addressing GOP lawmakers, July 19, 2017

“So pre-existing conditions are a tough deal. Because you are basically saying from the moment the insurance, you’re 21 years old, you start working and you’re paying $12 a year for insurance, and by the time you’re 70, you get a nice plan. Here’s something where you walk up and say, 'I want my insurance.' It’s a very tough deal, but it is something that we’re doing a good job of.” — Interview with New York Times, July 19, 2017 at Oval Office.